<p> Risk Management & Internal Control · SA4701 · 25800 Carlos Bee Blvd · Hayward, CA 94542 Telephone (510) 885-4227 Fax (510) 885-4908 </p><p>Return-to-Work Employee Information Sheet</p><p>California State University, East Bay values its employees and their contributions; therefore, the University strives to provide an injured or disabled employee the opportunity to return to work as soon as his/her condition permits. Transitional work allows an employee with temporary work restrictions to work in a modified, alternative, or reduced-hours capacity on a temporary basis, while recuperating from an illness or injury. Your treating physician has released you for transitional work and your department can accommodate your work restrictions. Depending on the nature of your work restrictions, your transitional work may or may not be that different from your regular job. Your supervisor will discuss the details of your transitional work plan with you. These details will be documented in a Return-to-Work Agreement so that your supervisor and you will both have a clear understanding of your job duties and/or work restrictions. Please remember this is not a permanent position; it is only temporary. If your transitional job is full-time, you will receive your regular pay and benefits during your transitional assignment. If you have only been released to work on a part-time basis, your pay, benefits, and hours will be adjusted accordingly. </p><p>To ensure a successful return to work, your cooperation is vital. You need to be an active participant in this program to make it work. Therefore, the following provides some guidelines for you to follow:</p><p> Follow the work restrictions recommended by your physician. If asked to perform a task that exceeds your restrictions or you feel unable to perform a task, it is your responsibility to immediately notify your supervisor. </p><p> Follow all work and safety rules at the location of your modified or alternative work assignment.</p><p> Total working hours are not to exceed physician recommendations. </p><p> Notify your supervisor by the start of your shift if you are unable to report to work for any reason.</p><p> Try to schedule doctor and physical therapy appointments at time when you are not scheduled to work. If you must leave work, you must receive prior approval from your supervisor.</p><p> Perform your modified or alternative work duties in a professional and responsible manner, just as you would in your regular position.</p><p> Once you are returned to work, but are still under the care of a physician, the CSU policy states--“If an employee loses work time for doctor’s appointments, physical therapy, medical procedures …such absences shall be charged to the employee’s leave credits”. </p><p> Notify your supervisor and Human Resources immediately, and provide medical documentation, if your physician: o Takes you off of work. o Changes your work restrictions. o Releases you to your regular position, without work restrictions. </p><p>If you have any questions or concerns with the Return-to-Work Program, please contact your supervisor or the Workers’ Compensation Coordinator in Risk Management at (510) 885-4227.</p><p>______Employee’s Signature Date reviewed and received copy</p>